Burt Ashley M, Huang Brady K
Department of Radiology, University of California San Diego, 200 West Arbor Drive, Mail Code: 8756, San Diego, CA 92130, USA.
SICOT J. 2017;3:34. doi: 10.1051/sicotj/2017015. Epub 2017 May 5.
Lipomatous lesions are common musculoskeletal lesions that can arise within the soft tissues, bone, neurovascular structures, and synovium. The majority of these lesions are benign, and many of the benign lesions can be diagnosed by radiologic evaluation. However, radiologic differences between benign and malignant lipomatous lesions may be subtle and pathologic correlation is often needed. The use of sonography, computed tomography (CT), and magnetic resonance imaging (MRI) is useful not only in portraying fat within the lesion, but also for evaluating the presence and extent of soft tissue components. Lipomas make up most soft tissue lipomatous lesions, but careful evaluation must be performed to distinguish these lesions from a low-grade liposarcoma. In addition to the imaging appearance, the location of the lesion and the patient demographics can be utilized to help diagnose other soft tissue lipomatous lesions, such as elastofibroma dorsi, angiolipoma, lipoblastoma, and hibernoma. Osseous lipomatous lesions such as a parosteal lipoma and intraosseous lipoma occur less commonly as their soft tissue counterpart, but are also benign. Neurovascular and synovial lipomatous lesions are much rarer lesions but demonstrate more classic radiologic findings, particularly on MRI. A review of the clinical, radiologic, and pathologic characteristics of these lesions is presented.
脂肪瘤样病变是常见的肌肉骨骼病变，可发生于软组织、骨骼、神经血管结构和滑膜内。这些病变大多数是良性的，许多良性病变可通过影像学评估进行诊断。然而，良性和恶性脂肪瘤样病变之间的影像学差异可能很细微，通常需要病理对照。超声、计算机断层扫描（CT）和磁共振成像（MRI）的应用不仅有助于显示病变内的脂肪，还可用于评估软组织成分的存在及范围。脂肪瘤构成了大多数软组织脂肪瘤样病变，但必须进行仔细评估，以将这些病变与低级别脂肪肉瘤区分开来。除了影像学表现外，病变的位置和患者特征也可用于帮助诊断其他软组织脂肪瘤样病变，如背部弹力纤维瘤、血管脂肪瘤、脂肪母细胞瘤和冬眠瘤。骨脂肪瘤样病变，如骨旁脂肪瘤和骨内脂肪瘤，比其软组织对应病变少见，但也是良性的。神经血管和滑膜脂肪瘤样病变更为罕见，但具有更典型的影像学表现，尤其是在MRI上。本文对这些病变的临床、影像学和病理特征进行了综述。
